Meissner P N, Harrison G G, Hift R J
MRC/UCT Liver Research Centre, University of Cape Town Medical School, Observatory, South Africa.
Br J Anaesth. 1991 Jan;66(1):60-5. doi: 10.1093/bja/66.1.60.
The choice of an i.v. anaesthetic induction poses problems for the anaesthetist confronted with a patient with one of the acute porphyrias. We undertook a prospective clinical trial in 13 variegate porphyric subjects using propofol as an anaesthetic induction agent. Urinary porphyrin precursors and porphyrins were measured before operation and 1-5 days after operation. Stool and plasma porphyrin concentrations were measured over the same period. Comparison of these data in the porphyric patients and in 21 control subjects over the trial period revealed no significant change in porphyrin or porphyrin precursor output after operation. Urinary porphyrin precursor concentrations did not exceed the limits established for variegate porphyric patients in remission, and there were no changes in the stool and plasma porphyrin profiles or any symptoms of an acute porphyric attack. We conclude that propofol did not appear to be porphyrinogenic when used for the induction of anaesthesia in 13 patients with variegate porphyria.
对于面对患有急性卟啉病之一的患者的麻醉医生而言，静脉麻醉诱导药物的选择存在问题。我们对13名杂合性卟啉病患者进行了一项前瞻性临床试验，使用丙泊酚作为麻醉诱导剂。在手术前以及手术后1 - 5天测量尿卟啉前体和卟啉。在同一时期测量粪便和血浆卟啉浓度。在试验期间，将这些卟啉病患者的数据与21名对照受试者的数据进行比较，结果显示术后卟啉或卟啉前体产量没有显著变化。尿卟啉前体浓度未超过为处于缓解期的杂合性卟啉病患者设定的限值，粪便和血浆卟啉谱没有变化，也没有急性卟啉病发作的任何症状。我们得出结论，在13名杂合性卟啉病患者中使用丙泊酚进行麻醉诱导时，它似乎不会引起卟啉生成。
